Division Of Welfare And Supportive Services Application For Assistance (Page 8 of 14) in pdf

STATE OF NEVADA

DEPARTMENT OF HEALTH AND HUMAN SERVICES

DIVISION OF WELFARE AND SUPPORTIVE SERVICES

NON-CUSTODIAL PARENT (NCP) FORM

When applying for TANF the law requires you to cooperate with Child Support Enforcement (CSE) to establish paternity to

get child support owed to you and/or any child(ren) that you are applying for. This may include genetic testing. If the test

proves the person you named is not the father, you may be required to pay the cost of the test. You are also responsible for

providing all available information requested by the CSE Program such as certified copies of divorce decrees and/or support

orders, birth certificates and photographs of the absent parent.

The CSE Program locates absent parents and/or sources of income and assets, establishes and enforces financial support,

reviews and adjusts existing child support orders, and collects and distributes financial payments.

The CSE Program has sole discretion in determining which legal remedies are used in pursuing support and cannot guarantee

success. CSE may request assistance of another state, and thereby, be subject to the laws of that state. CSE does not provide

services involving custody or visitation. CSE may close your case when your case meets closure rules established by federal

and state regulation.

The CSE Program represents the State of Nevada when providing services and no attorney-client privilege exists. CSE is

authorized to endorse and cash payments made payable to you for support payments and may collect past-due support by

intercepting an IRS tax refund or other federal payment. If a tax intercept occurs, the CSE Program has the authority to hold

a joint tax refund for a period of six (6) months before distributing the funds. No interest is paid on the held funds. Funds

collected from a tax intercept are applied first to pay off any past-due support assigned to the State of Nevada. A

nonrefundable fee is deducted by the federal government of any tax or federal payment intercepted by the CSE Program.

Good cause for not cooperating in pursuing child support or paternity may be allowed. If you do not cooperate with CSE

and good cause has not been determined, your household will be ineligible for TANF. Good cause for not cooperating will

be considered if you request it in writing. Examples of good cause are as follows:

● The child was conceived as a result of rape or incest.

● Legal proceedings for adoption of the child are pending before a court.

● You are being assisted by a public or licensed private social service agency to decide whether to keep or

relinquish the child for adoption (no longer than three (3) months).

● Your cooperation in establishing paternity or securing support will result in physical or emotional harm to

yourself or the child(ren).

You must provide your case manager with verification within twenty (20) days after claiming good cause. You will receive

written notification of the good cause decision. If you are found to have good cause for not cooperating, CSE will NOT

attempt to establish paternity or collect child support.

YES, I wish to claim good cause.

NO, I am not claiming good cause at this time.

______________________________________________________

Signature

You must report changes whenever a name change occurs; you have a new address or telephone number for home or work;

you hire a private attorney or collection agency; another child support or paternity legal action is filed; you file for divorce;

you receive support payments directly from the absent parent; you have a new address, telephone number, employment for

the absent parent; a child(ren) no longer lives with you; a child(ren) is still in high school after age 18; a child(ren) becomes

disabled before age 18; a child(ren) comes to live with you or you birth another child; a child marries, is adopted, joins the

armed forces or is declared an adult by court order.

You are responsible for repayment of support amounts received in error, including payments from an IRS tax refund, which

are adjusted by the IRS. If you fail to enter into a repayment agreement with the CSE Program, the outstanding balance may

be reported to a credit reporting agency and money collected on your behalf by the CSE Program may be withheld for

repayment. Additionally, legal action may be initiated against you.

Division Of Welfare And Supportive Services Application For Assistance Page 8

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